月经周期及绝经期间乳腺癌中雌激素和孕激素受体模式的变化

Changing estrogen and progesterone receptor patterns in breast carcinoma during the menstrual cycle and menopause.

作者信息

Pujol P, Daures J P, Thezenas S, Guilleux F, Rouanet P, Grenier J

机构信息

Service de Biologie Cellulaire, Centre Hospitalier Universitaire de Montpellier, France.

出版信息

Cancer. 1998 Aug 15;83(4):698-705.

PMID:9708933

Abstract

BACKGROUND

Estrogen receptor (ER) and progesterone receptor (PgR) status at the time of breast carcinoma surgery is used as a marker of both prognosis and hormone dependency to guide adjuvant therapy. The authors studied the influence of hormonal milieu at the time of surgery on ER and PgR levels.

METHODS

A population of 2020 patients with breast carcinoma, including 575 premenopausal women, was analyzed. ER and PgR levels were determined by radioligand binding assays (cutoff values, 10 fmol/mg). Serum estradiol (E2), progesterone (Pg), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) levels obtained on the day of surgery were used to define the menstrual cycle phase in premenopause.

RESULTS

In premenopause, there was a higher proportion of ER positive (ER+) tumors in the follicular phase (62%, n = 316) than in the ovulatory phase (51%, n = 59) and the luteal phase (53%, n = 200, P = 0.03). The mean ER level was also higher in the follicular phase (30 fmol/mg) than in the ovulatory phase (20 fmol/ mg) and the luteal phase (25 fmol/mg, P < 0.001). The percentage of PgR positive (PgR+) tumors tended to be higher in the ovulatory phase (85%) than in the follicular (78%) and luteal (72%) phases (P = 0.11). The mean PgR was also higher in the ovulatory phase (177 fmol/mg) than in the follicular and luteal phases (134 and 92 fmol/mg, respectively; P < 0.001). The percentage of ER+ tumors was higher among menopausal women than among premenopausal women (67% vs. 59%, respectively; P < 0.001). Conversely, the percentage of PgR+ tumors was lower among menopausal women than among premenopausal women (65% vs. 78%, respectively; P < 0.001). In premenopause, there was a weak negative correlation between ER and E2 levels. No correlations were found between levels of ER and Pg and levels of FSH and LH or among levels of PgR and E2, Pg, and FSH and LH in premenopausal and menopausal women.

CONCLUSIONS

Changes in ER and PgR levels in breast carcinoma during the menstrual cycle and menopause suggest that interpretations of hormone dependency on the basis of steroid receptor values should take into account hormonal status at the time of surgery.

摘要

背景

乳腺癌手术时的雌激素受体（ER）和孕激素受体（PgR）状态用作预后和激素依赖性的标志物，以指导辅助治疗。作者研究了手术时激素环境对ER和PgR水平的影响。

方法

分析了2020例乳腺癌患者，其中包括575例绝经前女性。通过放射配体结合试验测定ER和PgR水平（临界值为10 fmol/mg）。手术当天测得的血清雌二醇（E2）、孕酮（Pg）、促卵泡激素（FSH）和促黄体生成素（LH）水平用于确定绝经前的月经周期阶段。

结果

在绝经前，卵泡期ER阳性（ER+）肿瘤的比例（62%，n = 316）高于排卵期（51%，n = 59）和黄体期（53%，n = 200，P = 0.03）。卵泡期的平均ER水平（30 fmol/mg）也高于排卵期（20 fmol/mg）和黄体期（25 fmol/mg，P < 0.001）。PgR阳性（PgR+）肿瘤的百分比在排卵期（85%）有高于卵泡期（78%）和黄体期（72%）的趋势（P = 0.11）。排卵期的平均PgR水平（177 fmol/mg）也高于卵泡期和黄体期（分别为134和92 fmol/mg；P < 0.001）。绝经后女性中ER+肿瘤的百分比高于绝经前女性（分别为67%和59%；P < 0.001）。相反，绝经后女性中PgR+肿瘤的百分比低于绝经前女性（分别为65%和78%；P < 0.001）。在绝经前，ER与E2水平之间存在弱负相关。在绝经前和绝经后女性中，未发现ER和Pg水平与FSH和LH水平之间以及PgR与E2、Pg、FSH和LH水平之间存在相关性。